Governor's Office Emergency Services
Hazardous Materials Spill Report

DATE: 10/19/2021
TIME: 1111
RECEIVED BY: CONTROL#:
Cal OES - 21-5813
NRC - 1319853
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
NRC
1.b. PERSON REPORTING SPILL (If different from above):
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Oil=Unknown N/APETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Per the NRC Report

THE CALLER IS REPORTING A DISCHARGE OF AN UNKNOWN OIL FROM A
COMMERCIAL TRUCK PARKED AT THE LOCATION. THE CALLER STATED THAT
AFTER THE VEHICLE LEFT THE AREA, THERE WAS A DISCHARGE OF OIL ON THE
GROUND.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Unknown if stopped, Unknown if containedNoNo
l. MARITIME VESSEL
m. KNOWN IMPACT
3. a. INCIDENT LOCATION: 114 Santa Rosa Pl
b. CITY:c. COUNTY: d. ZIP:
Santa Barbara
Santa Barbara CountySANTA BARBARA COUNTY APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
10/19/20211400 Road Unknown
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
NRC
d. ADMIN. AGENCY: Santa Barbara County Environmental Health Servicese. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

3
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS
Photo Attachment:
11. Cal OES Reg.
********* Control No: 21-5813 *********

Created by: Warning Center on: 10/19/2021 11:11:54 AM Last Modified by: Warning Center on: 10/19/2021 11:16:38 AM